New thoughts? COMLEX ONLY for Family Med (or Peds) after ACGME agreement?

[bshoni22]

Hey all, I'm an OMSII taking Step 1 at the end of June. Even after 2 years of the ridiculousness that is med school I still want to be a doctor and I still (gasp) am attracted to Family Med. Maybe I've just drank the Kool-Aid but hey, I guess we'll see for sure next year on rotations.

I take my COMLEX June 25th and am signed up to take the USMLE on July 10th. Call me lazy, call me lame, call me late for dinner but even though there's no 100% for-sure answer to my question I was still wondering what you all think about just taking COMLEX and leaving the USMLE behind?

NOW the catch: I want to do residency and ultimately practice in South Florida (home) or California (college and family). I also want to keep Allopathic residency options available (not ruling out DO FM at all, just want as many choices as possible). I know a lot of MD FM programs accept COMLEX. Do you think that number will increase with the recent changes in the ACGME?

I know the standard advice is: "Take both, why limit your options?" but anyone who's gone through two years of med school and is 98-99% sure they want to go into FM (peds and IM too possibly depending on 3rd year experiences) should be able to understand the deep, GNAWING desire to just finish with 2nd year (as strongly as possible of course and re-enter the world of the living.

Any and all advice or thoughts are welcome. Hell, feel free to call me an idiot, A-hole, ******* etc. if it'll make you feel better. I'm here to help.
Thanks. JB

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[Elisabeth Kate]

If you want CA, I think you need to take the USMLE. CA is ridiculously competitive in all specialties. Also, consider what happens if you go through third year and discover a love for another specialty. Studying for the USMLE during clerkships is a bigger pain than studying for it now.

 

[babdoc]

I know the standard advice is: "Take both, why limit your options?" but anyone who's gone through two years of med school and is 98-99% sure they want to go into FM

My initial advice would be: don't limit your options. However, you've obviously heard that before. Then you bring up the second point above: 98-99% sure.

There's no way to be sure, even that sure. You could think you're sure, but then you get into your FM, IM, and peds rotations and find out it's not what you want to do. I'm not dissing the primary care specialties by any means (I'm going to do primary care IM). A lot of people find out that they want to do something different when they get to rotations. Something else might spark your interest. Or you might find out you don't like what you thought you would. It's no big deal; that's what rotations are all about.

So, that said, there is always a chance you will change your mind even if you are very very...very sure. The end of second year is very time consuming, anxiety-provoking, and all-around draining. Power through. Take time for yourself and keep working hard. Step 1/Level 1 is important. In fact, my alma mater will begin requiring both the COMLEX and USMLE, if what I've heard is true. It's very helpful to do both. No one knows what will come out of the unified GME system or if it will be done by the time you match.

Put the work in to get both done well. Take one day at a time and it will be over before you know it.

 

[pattr]

Take USMLE Step 1, aim for at least average (~227), and if you still decide on FM after third year, you can have your pick out of most of the California FM programs. I can't comment on South Florida since I don't have experience with them, but especially in CA, you will need a USMLE score to compete, even in FM.

 

[Trogghunter]

If you can do well on your comlex 1 2 and pe and have the scores by the time eras opens, you'd be fine. I'd shoot for >600. I think that even Duke takes comlex only for FM.

 

[bshoni22]

You're right babdoc. Thanks for the dose of perspective.

 

[pattr]

Also, with all three primary care specialties being fair game right now, keep in mind that for IM and peds you are even more likely to need to have a competitive USMLE Step 1 score in hand for a solid chance at ACGME programs.

 

[BigSib]

...I was still wondering what you all think about just taking COMLEX and leaving the USMLE behind? ... Do you think that number will increase with the recent changes in the ACGME?

This question cannot be answered by students alone. You would need program directors and COM faculty to weigh in on this one. It could go both ways: only the USMLE matters and the COMLEX phases out or becomes a smaller add-on to the USMLE - or - the COMLEX becomes the standard (for potentially the primary care specialties) with the USMLE reserved for specialties in the SF match or for programs that historically do not have DO residents. There is no way to know.

... I want to do [an FM] residency and ultimately practice in South Florida (home) or California (college and family). I also want to keep Allopathic residency options available (not ruling out DO FM at all, just want as many choices as possible). I know a lot of MD FM programs accept COMLEX. ...

Look into how many of the FM programs in these states/regions are dually-accredited. Unfortunately, from a brief skim of the FM programs in FL/CA, it doesn't appear there are many dually-accredited sites in those areas. If you have your eye on a few programs in particular, it would be wise to call the sites and ask if they accept the COMLEX - most residency coordinators are friendly and kindly provide you with this information. It is also likely on the program's website as well. However, don't be surprised if you get an answer in-between yes and no or something along the lines of "we prefer the USMLE." So, if you're okay with potentially not being considered by some that are ACGME-only and you are very interested in a lot of the osteopathic programs in those areas, then you should only take the COMLEX.

Taking only the COMLEX and only participating in the AOA match makes things a lot easier for you (granted that there would still be two separate matches that year) and the program as well. Obviously it would make your life easier by not having to study for the extra test. Regardless of whether you take the USMLE though, the programs at dually-accredited sites will ask which match you intend to participate in - even if you didn't take the USMLE. If you say that you're participating in both matches, some program faculty may view this as you having some kind of unknown agenda, whereas others don't even think about it. It can be a headache to keep track of where to rank the applicants.

Overall, in your situation, because you want to be in FL/CA and want to consider allopathic programs, it sounds like you should take the USMLE.

 

[Makati2008]

If you want do FM That's not dually accredited then you'll be fine. Mount Sinai in Miami didn't fill for fm and I know Largo FM you just need to pass the comlex for a chance

 

[Dharma]

Folks… take the USMLE, unless you are 100% sure you are ok with closing doors before having the chance to knock.

 

[primadonna22274]

Since you've already paid for USMLE, go ahead and take it. You won't get a refund and they won't give you a credit for any future exam (I know, I wanted to cancel but since I had already paid $650 for it I wasn't about to waste the money and ended up with a slightly below-average but very comfortably passing score).
I don't think that my USMLE score made a lick of difference in any of my interviews or final residency choice. What did make a difference is I kicked butt on step 2, but only took COMLEX for that--was out of money by then lol. I interviewed at allo and a couple dually-accredited FM and IM programs in the southeast and it was no problem at all.